What Does the Word “Psychosomatic” Really Mean? A Historical and Semantic Inquiry

Abstract

Semantics and history of psychosomatic medicine are not popular topics nowadays, if they ever were; yet both of them constitute indispensable facets of any discipline that lays claim to a separate identity, as psychosomatics does. The latter, being an inchoate and inherently complex field of study, is especially in need of repeated efforts to clarify the meaning of its key terms, to delineate its scope, and to chart its development over time. Such efforts should pay off in improved teaching of this subject and in more effective communication with workers in other disciplines and with the general public. I have tried in this paper to sketch the historic development of psychosomatic conceptions and address some relevant semantic issues. It appears that early in this century, the convergence of two ancient conceptions, the holistic and the psychogenic, prepared the ground for the emergence in the 1930s of psychosomatic medicine as an organized scientific discipline and a counterreformation against the mechanistic view of man and medicine. Those two conceptions came to be subsumed by the word "psychosomatic" and thus contributed its two distinct connotations. The latter have not usually been clearly distinguished; hence, the ambiguity of the term. I have argued that only the holistic connotation should be retained, as it properly conveys the contemporary viewpoint. It is unfortunate that the word "holistic" has been appropriated recently by an anti-scientific and antiintellectual so-called "holistic health movement" (67), with resulting increment in semantic confusion and, in the eyes of many, loss of credibility for the misappropriated term. However, to retain it has merit as it is short, simple, and derived from the Greek - as were the very conceptions it has come to connote. Moreover, "holistic" has been part of the basic vocabulary of psychosomatic medicine from the beginning and conveys its core premises and purpose faithfully. As a historian aptly put it, the historic function of the psychosomatic movement has been to "vitalize the whole of medicine, psychiatry no less . . . with the holistic and ecologic viewpoint" (59, p. 9).(ABSTRACT TRUNCATED AT 400 WORDS)

Review of the conceptual classes of somatization, hysteria and conversion

“…Mivel erre a kérdésre a konverzió megközelítéseit áttekintve röviden visszatérek, itt elegendô annak rögzítése, hogy jelenségtani rokonaival ellentétben a szomatizáció fogalma elválaszthatatlan az orvosi felfogás általános hát-terét alkotó nyugat-európai filozófiai hagyomány modernkori ontologizá-ló szemléletétôl, s történeti gyökerei az anakronizmus veszélye nélkül csak a XVII-XVIII. századig követhetôk vissza (Lipowski 1984).…”

“…A természettudományok módszertanának uralkodóvá válása, a technicizálódás, a betegségek modern ontológiai felfogása, az orvosi szemiológia, s a nyomában születô leíró pszichopatológia, valamint a XVIII-XIX. szá-zadban önállósodó pszichiátria és pszichológia önlegitimációs erôfeszíté-sei teremtik meg azt az általános ismeretelméleti hátteret, amelyen megszületik a nyugati orvoslás jellegzetes fogalmaként a szomatizáció koncepciója (Lipowski 1984).…”

“…Ez a megközelítés az orvostudományban honos nyelvhasználat rejtett episztemológiai feltevéseinek elemzésére támaszkodva arra a következte-tésre jut, hogy számos betegségkategória (különösen a szomatoform zavaroké) nem valóban létezô állapotok leírására szolgál, csupán egy filozófi-ailag túlhaladott és tarthatatlan, ám reflektálatlanul maradó duális ontológiai szemlélet mesterséges lingvisztikai következménye (Graham 1961;Lipowski 1984;McWhinney és mtsai 1997).…”

Psychosomatic Medicine

“…This section is intended to highlight articles of particular interest and of high quality from all aspects of psychosomatic medicine. The term "psychosomatic medicine", applied here in its broadest sense, refers to the study of the interplay between biological and psychosocial factors in the development, course, and outcome of diseases (1). Such biological-psychological interactions are relevant at such levels as the biophysiological, behavioural, and psychological.…”

“…As was recently argued (3), the schism which has sometimes existed between consultationliaison psychiatry and the scientific foundations of psychosomatic medicine seems inappropriate and counterproductive. Readers interested in the historical aspects of these fields and the interrelationships between them are referred to a number of recent reviews (1,(4)(5)(6)(7)(8).…”